Treatment of Type C2 and C3 Pilon Fracture of Distal Tibia by Limited Open Reduction and Mini Plate and Transarticular Kirschner Wires Fixation

Abstract

Background and Objectives: The optimal treatment for Pilon fractures remains controversial. This study was conducted to evaluate the clinical outcome of the treatment of type C2 and C3 Pilon fractures (AO/OTA Classification) using limited open reduction and fixation with mini-plate and supplementary transarticular Kirschner wire. Materials and Methods: 31 type C2 and C3 Pilon fractures, including 5 open fractures, were included in this study. For 10 patients, including 5 open fractures, temporary external fixation spanning ankle joint was conducted as early as possible. Other 21 patients were temporarily immobilized in splint. At the final stage, tibial and fibular fractures were reduced and fixed using limited open reduction and transarticular Kirschner wires and mini-plates. Clinical and radiographic evaluations were performed. The American Orthopedic foot and Ankle Society Score (AOFAS) were obtained for the evaluation of function. Results: Anatomic reduction in articular surface was obtained in 29 (94%) patients. No nonunion or skin necrosis was observed during the follow up period. Minor infection occurred in 2 patients and deep infection occurred in 1 patient. Malunion occurred in 3 (9%) patients. The final functional results, based on the AOFAS score, were excellent and good in 74.41%, average in 19.35% and poor in 3.22% of the patients. Conclusion: Limited open reduction and fixation with mini-plate and transarticular Kirschner wires is a reliable treatment for closed and open AO/OTA type C2 and C3 Pilon fracture of the distal tibia.